Searching for harmony: one music therapist’s journey towards self-care

Searching for Harmony: One Music Therapist’s
Journey Towards Self-Care
Linda Dessau, MTA

Why is self-care is important to me?
Self-care is important to me, largely because I want to feel better, emotionally and physically. I also want to decrease my risks of illness and injury. I know that I have the power to do these things, with a positive attitude and with self-care habits. Why is self-care important to me as a music therapist? I chose this profession because I am a caregiver by nature, or “giver” for short. Like many caregivers, I sometimes have a hard time stepping back and identifying my own needs. Once I have, it can be difficult if not impossible to assert myself to get those needs met. As a defense mechanism, I sometimes “choose my battles”, compromising a little bit at a time until I realize that my life is not the way I want it to be anymore. This makes me vulnerable to stress and stress-related illness. I am very fulfilled by my work, and I try to think each day about how lucky I am to go to work and do what I feel I was meant to do. My work and my clients give me a lot of energy, but they take a lot of energy, too. My clients, who I hold so dear, can have a negative or “toxic” effect on me. Their expressions of grief, sadness, anger and euphoria can be powerful and difficult to contain. I recently came across a workshop description from a Feng Shui practitioner, offering to help therapists “clear stuck energy” from their clients that might remain in the room after they’re gone. I think she has something there. The staff that I work with, if they are also affected negatively by the clients, and stressed out themselves, can be a very negative influence on me, if I let them. This was a serious problem at one point in my life. I’m lucky now to work with people who, for the most part, are as patient and caring as I try to be. However, relationships with clients and staff can make me vulnerable to stress and stress-related illness. Music therapy holds incredible cognitive, physical and emotional challenges. When I am reading a new piece of music that a client requested, observing group dynamics, reflecting on the news that another client passed away, responding to a staff member who has just caught my eye to tell me that she has to deliver medication to someone, and I am concentrating on holding my posture so that I am not straining my back, I am amazed that I can still remember how to play the guitar, let alone the names of any of my clients. Just imagine all of the things that can be going on at the same time when you are working. Underlying anger and stress created by these challenges and by our connections to these people can be very dangerous to our health and extremely detrimental to our clients. From the traditional Chinese Five Phases system, I learned that the “water” person (the caring therapist) can be easily depleted by stress and anger. Stress adversely affects virtually every system in our body. Stress can be responsible for colds that take a long time to get better, depression, aches and pains, headaches, sleeping problems, as well as some serious and life-threatening illness. Why is self care important to me as a traveling music therapist in private practice? All of the above reasons apply, plus additional challenges and stressors. Though I try to incorporate benefits into my fee, I still find myself thinking twice about taking a sick day (“how many paid hours have I already missed this month?”), on the days that I am self-employed (three days a week, in my case). My goal is to let my body decide, no matter what day it is! When I work in two or three locations on the same day I sometimes find it hard to “switch gears”. The traveling can be a nice chance to listen to good music in the car and enjoy a sunny day, but obviously traffic snarls or bad weather can quickly change that situation. And it’s not long after getting out of the car that I have to be “on” again. Not only do I work in isolation from other music therapists, but I also find that when I begin working somewhere for one hour a week it takes a long time to connect with other staff members, both clinically and personally, and this can be isolating as well. Traveling from place to place also means that I am lifting equipment in and out of It is for all of these reasons that I find myself very committed to learning about and practicing self-care. It’s been an ongoing process for me, and I hope that it goes on for a long time still. I’ve loved the learning, and I also love to share what I’ve learned and help other people have healthier, less stressful lives. Please note that in my presentation at the conference I will be describing my own life-altering experiences that led me to seek out self-care resources. I will not be including that discussion in these pages. What has worked for me, and what might work for you General I think it’s important to prepare for any major changes you’re planning to make in your life. Focus on one change at a time and don’t change something else until the first change has become second nature. Also, try to set realistic goals that involve an action – instead of “I will lose weight” try “I will exercise 3 times a week”. Evaluate your body mechanics, posture and anything that is causing you to strain or push your body’s limits. You can enlist the help of an ergonomic expert or a physiotherapist or you can try it yourself. For one day, or maybe for a whole week, become very aware of your movements during the day, especially the repetitive ones. Notice anything that causes strain or pain, or just things you didn’t realize you were doing so much (lifting, bending, carrying). One of the major things I found to be a strain was my guitar playing. This was because of the positions I was putting myself in (leaning forward or twisting to interact with clients), the chairs I was sitting in (chairs with arms which forced me to sit at their edge and have no back support), and the size of my guitar (to wrap my arms around it I was putting a strain on my back - I now play a very small “parlour” size guitar made by Art and Lutherie). I also had to look at what I was carrying around with me during the day. Did I really need my client’s entire history and all of my notes at each session? I began to carry just a few blank progress notes sheets, which I transferred to the client’s binder at the end of the day. I also decided to use a wheeled cart (a luggage carrier with a collapsible box on top of it, held on by bungee cords), so that from my apartment to the car, and from the car to my work place(s), I don’t have to carry anything by hand. I use a soft “gig bag” for my guitar, instead of the heavier hard case option. During sessions, I can use my cart as a guitar stand. I try to put my guitar down when I can. And if I need to be reading music I try to have a proper music stand so I’m not straining to lean over to see my music from the floor, a low chair or my lap. Everyone’s body and situation are unique, so it’s important to do your own analysis of how you’re moving during the day and where your problems might arise - you don’t have to wait until something goes wrong! Nutrition Nothing affects how we feel and how we function like what we eat – recognize this and plan ahead; we’re more likely to make unhealthy choices when we’re grabbing things on the run. I plan my meals ahead for the week – that way my grocery shopping is a lot easier. I plan frozen leftovers for busy days, and cooking for lighter days. I follow a particular food plan, which I will describe in a moment. Any food plan that works for you is fine, though if it strays too far from Canada’s Food Guide (see reference list) then it might not be safe, or it might not be something that you can adapt as a lifestyle over the long term. The food plan that I’m on is geared toward people with addictive eating behaviour, and addictive behaviour in general. Kathleen DesMaisons, who was the first person to get a Ph.D. in addictive nutrition, developed the plan. She has written several books, and the one I would recommend is “The Sugar Addicts Total Recovery Program”. There is also a very helpful website (see reference list), which has a questionnaire to help you decide if you are “sugar sensitive”. One of my favourite ideas from this plan is to think of it as a program of abundance not denial. I have adapted this idea and shared it with the Living with Stress group at the Aphasia Institute (for adults with chronic aphasia). I suggest: Don’t think about what you have to take away from your diet, think about what healthy foods you can add in. For example, if you decide to aim for the recommended 5-10 servings of fruit and vegetables every day, you will be giving your body important nutrients, you will feel better, and you will likely have less room for the things that aren’t as healthy. Over and above any food plan, it’s important to drink lots of water. Water helps with everything, from flushing out toxins, to lubricating joints, to improving dental health, to losing weight, to giving you more energy, to helping you think clearly. Eight to ten glasses a day, more if you drink caffeine or if you exercise intensely. According to Running Room magazine, the way to tell if you’re properly hydrated is if your urine is clear. If it’s not, then you’re not drinking enough water. One thing I had to do when I started watching carefully what I was eating was learn to cook! There are lots of ingredients in prepared and packaged foods that aren’t good for me (some that aren’t good for anybody). I’m still learning, but I’m a lot more capable in the kitchen then I was a few years ago. And I actually enjoy it. There are a few recipes attached, and I’ve included some cookbooks in the reference list. Exercise Try to do less nothing and more something. This idea was what got me off the couch. Instead of spending the evening with the remote control, I got out and did something – I went to the mall and window shopped, I went over to someone’s house for a visit (social contact is also very important to combat stress and when you live alone it’s something you have to work at). Or I stayed in and did something – re-organized a part of my apartment or did some dusting. From there I moved on to joining a gym and doing a more structured exercise program. I think a great place to start is Canada’s Physical Activity Guide. I have been using this with the Living with Stress group and I think it’s an excellent resource. I think the most important ideas from there are to start small (10 minutes at a time adds up!) and find something you enjoy doing. Sleep Sleep hygiene tips will be discussed in detail in my presentation, including suggestions such as waking up at the same time every day, writing down troubling thoughts before bed so you can deal with them the next day, and avoiding things like exercise, caffeine, nicotine or alcohol for a few hours before bedtime." Emotional well-being / Stress management Take inventory and build a team. “Taoism would suggest that you live in accordance with nature….it would be wise to become sensitive to the nature within yourself. If you’re doing something you don’t feel comfortable doing, don’t do it anymore”. I found that quote in an article about acupuncture, and it truly was an epiphany. For me, combating stress started with taking an inventory of things that I didn’t feel good about, where I felt “out of balance” or in “disharmony”. Then I tackled what I could, and enlisted help where I could get it – a wonderful therapist, a music therapist to consult with, and staying in close contact with my peers in the Toronto Area Music Therapists group and by joining the MTAO board as secretary. This is an ongoing process, and I sometimes find myself back on that edge and taking inventory again. Have a “Plan B”. This is from a book called “Fight fat after forty”, by Pamela Peeke. Think of Plan A as your basic self-care plan while stress is under control. Now imagine something happens and you are under stress. Instead of abandoning all self-care because you can’t do it all, have a Plan B ready beforehand. Think of it as your bottom line – you might give up your 30-minute walk, but you lift soup cans for ten minutes. Sometimes when your Plan B period is over you get right back to Plan A. Other times, if you’ve had an illness or injury, it could mean coming up with a new Plan A. Have a positive attitude. One of things I’ve worked on is cognitive reframing - checking out how I react to things and people, and looking at them in a different way. I worked on learning to avoid things like jumping to conclusions and black-and-white thinking, and I worked on trying to put a positive spin on things instead of a negative one. It’s not always easy, and it’s certainly not my first impulse sometimes, but I’m more aware of my thinking patterns now. Explore musical and other creative outlets. Some music therapists find wellness through performing, working with a creative arts therapist, writing music, song leading,
or using music or another art form in a personally fulfilling way that is for them and not
for clients. I haven’t really found that outlet yet, but I do have some ideas of things I’d
like to try. In some ways I feel like I have to get everything else in balance first, even
though I know that finding somewhere to sing or dance would probably help that along.
And still I resist. That’s one point on the journey that I still have to look forward to.
I’ve taken care to include all of my sources here. However, I do a lot of reading about self-care, and
participate in discussion groups and informal conversations about it. Therefore, some ideas I have absorbed
from unknown sources.
Annotated Bibliography

The Art of Practicing: a guide to making music from the heart, by Madeline Bruser (New
York: Bell Tower, 1997). The author discusses ways of practicing and playing, to avoid
injury and increase the meaningfulness and joy of your time with your instrument.
Change your brain, change your life, by Daniel G. Amen, M.D. (New York: Three
Rivers Press, 1998). This is a fascinating book about how many problems can be linked
to abnormalities in the brain. I haven’t delved into this book as deeply as I hope to in the
future – to better understand both my clients and myself. I particularly liked the non-
medicinal prescriptions. For example, for a problem in the deep limbic system that might
manifest as depression or problems in intimate relationships, one of the things Dr. Amen
recommends is to “build a library of wonderful memories”. He explains that you can
actually relive positive moods and feelings by thinking about a pleasurable experience.
The Easy Does it Yoga Trainers Guide, by Alice Christensen (Iowa: Kendall/Hunt
Publishing Company, 1995). Excellent resource for teaching gentle yoga stretches and
poses to people with special needs.
Fight fat after forty, by Pamela Peeke, M.D., M.P.H. (New York: Viking, 2000). Good
information about the connection between stress and eating. Includes a detailed plan of
exercise and nutrition.
The fibromyalgia advocate, by Devin J.Starlanyl, M.D. (Oakland: New Harbinger
Publications, Inc. 1998).
Relax, you may only have a few minutes left: Using the power of humor to overcome
stress in your life and work, by Loretta LaRoche (New York: Villard, 1998). A great
book full of relaxation tips, hilarious stories and touching truths.
The Sugar Addicts Total Recovery Program, by Kathleen DesMaisons, Ph.D. (New York:
The Ballantine Publishing Group, 2000). This book presents a health and nutrition
program for people who are sugar sensitive. It includes shopping and cooking tips,
recipes, and the complete seven-step plan for recovery. Also see the Radiant Recovery
website below. (Her first book, Potatoes not Prozac, New York: Simon & Schuster,
1999, delves more into the science behind sugar sensitivity).
Other

Checklist of Cognitive Distortions, copyright 1980 David Burns, MD.
Websites

Chatelaine Wheel of Life http://spotlight.chatelaine.com/wheel/wheel.html A good place
to start if you’re evaluating the areas of your life you’re not satisfied with.
Radiant Recovery http://www.radiantrecovery.com The website for Kathleen
DesMaisons (Sugar Addicts Total Recovery Program, Potatoes not Prozac) –
information about the 7 steps of the program, a large collection of recipes, and a
questionnaire to tell you if you are sugar sensitive.
Canada’s Food Guide http://www.hc-sc.gc.ca/hppb/nutrition/pube/foodguid/index.html
Includes the food guide as well as several other publications that you can order online.
Heart and Stroke Foundation http://www.heartandstroke.ca Click on “healthy living”, and
then “healthy eating”. Refers to and expands on Canada’s Food Guide.
Canada’s Physical Activity Guide http://www.hc-sc.gc.ca/hppb/paguide/ The guide as
well as other publications that you can order online.
Chatelaine Sweat Central http://sweatcentral.chatelaine.com/training/index.htm
Information and tips about exercise. There are lots of other helpful things at the
Chatelaine site.
Miriam Nelson http://www.strongwomen.com/ Excellent resource, and her books come
highly recommended.
Running Room http://www.runningroom.com/ THE resource for runners.
Canadian Lung Association http://www.sk.lung.ca/smoking/index.html A wonderful
program to help with quitting smoking.
Quit meter http://www.mwilden.com/QuitTime/index.html A way to track your progress
when you quit – very motivating.
Musician’s clinic of Canada http://www.musiciansclinics.com/index.asp Dr. John Chong
specializes in the prevention and treatment of injury for musicians. He takes a holistic
approach and helps pinpoint the emotional, physical and mental factors that impact these
types of injuries.
Feng Shui Toronto http://www.interlog.com/~fengshui/ Explanation of feng shui, feng
shui services and workshops.
The Fly Lady http://www.flylady.net/index.asp Clear clutter and get organized. Lots of
tips and lots of fun.
Acupuncture http://www.acupuncture.com/ Information about traditional Chinese
medicine.
Magazines

Wellness Letter http://www.wellnessletter.com/ A newsletter printed at the University of
California at Berkeley, that specializes in “de-bunking” fad products that make
outrageous claims about their healing benefits. Always lots of great health information,
empowering people with knowledge so they can improve their health and wellness.

Recipe Books

How to cook everything, by Mark Bittman (New York: Macmillan, 1998). Truly includes
everything. Great for reference.
The Lighthearted Cookbook, by Anne Lindsay (Key Porter Books, 1988). Published
jointly with the Heart and Stroke Foundation.
Lighthearted Everyday Cooking, by Anne Lindsay (Macmillan of Canada, 1991).
Published jointly with the Heart and Stroke Foundation.
Anne Lindsay’s New Light Cooking, by Anne Lindsay (Ballantine Books, 1998). Written
in cooperation with the Canadian Medical Association.
Simply HeartSmart Cooking, by Bonnie Stern (Random House of Canada, 1994).
Published with the cooperation of the Heart and Stroke Foundation of Canada.
Good Food Fast, by Bev Callaghan, RD and Lynn Roblin, RD (Toronto: Robert Rose, Inc. 2000). From the Dieticians of Canada.

Source: http://www.musictherapy.ca/documents/confproc/2002/Linda%20Dessau%20-%20Searching%20for%20Harmony.pdf